Denial Coordinator
Centene Corporation - Toledo, OH

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Position Purpose:
Generate and process denial letters and Notice of Action (NOA) for pre-services, leveling of care and denied medical services.

High school diploma or equivalent. 2+ years of related managed care experience and medical terminology. Associate’s degree preferred.

Position Responsibilities:

• Maintain the denial and/or appeals logs and assessments in accordance with associated guidelines

• Responsible for the Medical Management denial process including letter printing, tracking and disposition of letters within contractual guidelines to ensure compliance

• Serve as the department liaison for all denial and/or appeals issues

• Train others on denial and/or appeals work processes

• Prepare monthly, quarterly, and annual reports for denials and/or appeals

• Review log to ensure compliance with the denial process and turn-around timeframe (TAT) for all denial and/or appeals notifications

About this company
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Centene is sensitive to the needs of individuals and families enrolled in government-assisted health programs. The company provides managed...